- Detroit Medical Center (Detroit, MI)
- …Performing accurate medical necessity screening and timely submission for Physician Advisor reviews Collaborating with payors, physicians, office staff and ancillary ... process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable admissions Discusses with the attending status… more
- Atrium Health (Charlotte, NC)
- …and understanding of severity based DRG systems; All-Patient Refined and Medicare Severity (APR-DRG), Medical Severity Diagnostic Related Group System (MS-DRG) and ... Hierarchical Condition Categories (HCC). Interacts with the physician advisor , attending physicians, and/or other designated members of the healthcare team when… more
- Marion County (Salem, OR)
- …operational plans to achieve desired outcomes. Serve as a policy advisor to executive leadership to formulate recommendations, policy decisions and strategic ... be excluded from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide health benefits); AND must… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Medicare MAP Advisor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #266 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ... the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor - Will promote and sale MAP and Medicare Line of Business,… more
- The Cigna Group (Bloomfield, CT)
- **Remote, work from home - United States** **Summary** The Business Analytics Senior Advisor position within the Medicare Growth Analytics Team is an opportunity ... to provide leadership on our analytics strategy, to support our broader Medicare Growth team and provide actionable insights and analytics. This role will work with… more
- Adecco US, Inc. (Woonsocket, RI)
- …may depend upon experience, education, geographic location and other factors. As an RPh Advisor you will be directly supporting Medicare Part D members and ... currently assisting a National Pharmaceutical client, recruiting for a REMOTE Clinical Medicare Pharmacist. Apply Now! The schedule is as follows: Monday through… more
- The Cigna Group (Atlanta, GA)
- **Marketing Advisor , DTC Advertising ( Medicare Advantage) - Hybrid** Responsible for day-to-day management of direct-to-consumer advertising. Play a pivotal role ... with other channels, meet brand standards and can positively impact Cigna's Medicare Advantage growth goals. **Responsibilities** + Partner to provide the strategic… more
- The Cigna Group (Franklin, TN)
- …or (4) as otherwise requested. + Other responsibilities as assigned by the Medicare Contracting Senior Advisor (M POSITION REQUIREMENTS: + **Bachelor's degree ... and will work in the Franklin, TN office several days per week** ** Medicare Advantage position** The **Provider Contracting Lead Analyst** serves as an integral… more
- The Cigna Group (Morris Plains, NJ)
- **POSITION SUMMARY:** The Network Advisor is responsible for initiating maintenance and strategy solutions for all Centene Lines of Business. Responsible for the ... planning, internal coordination, maintenance, and communication of client Network activities and performance for Line of Business initiatives while maintaining key client relationships. Utilizes technology, tools, processes and resources to anticipate and… more
- Centers Plan for Healthy Living (Bronx, NY)
- …plans they need for healthy living. JOB SUMMARY : The Licensed Benefits Advisor - Medicare Sales, Maintains relationships, services our existing customers and ... Licensed Benefits Advisor (Field Based) Bronx, NY, USA * Brooklyn,...in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and… more
- The Cigna Group (Philadelphia, PA)
- The Program Management Senior Advisor position is part of the Part D Stars Team within the larger Stars Center of Excellence department at Cigna Medicare . This ... for developing and executing enterprise strategies to improve Cigna's Medicare Part D Star measures and related quality measures....will work closely with matrix partners within the Cigna Medicare Stars and Risk Adjustment organization as well as… more
- Humana (Tallahassee, FL)
- …the 'Face of CenterWell Pharmacy' through an account management/service function. They support Medicare Regions as pharmacy advisor on a wide variety of topics ... Pharmacy Lead is a key stakeholder to Pharmacy and Medicare Retail organization leadership in the management of Value...etc.) **Use your skills to make an impact** + ** Medicare Region + Provider Account Management (50%)** + CPLs… more
- The Cigna Group (Houston, TX)
- **Job Summary:** The Medicare Coding Quality Review Audit Manager is responsible for day-to-day oversight of the Risk Adjustment coding quality assurance operations ... for the Cigna Medicare segment. This role receives support from the MDQO...as designed + Works closely with Quality Review Audit Advisor to ensure Risk Adjustment coding activities performed by… more
- Randstad US (Houston, TX)
- virtual benefit advisor - 50 state license. + houston , texas (remote) + posted may 30, 2024 **job details** summary + $30 - $33 per hour + temp to perm + high ... the Job for you! As a Licensed Virtual Benefits Advisor , individuals will be able to handle all responsibilities...health, prescription drug, vision and dental plans, and advising Pre- Medicare eligible recipients of their options. This is done… more
- Randstad US (Charlotte, NC)
- virtual licensed benefit advisor . + charlotte , north carolina (remote) + posted may 28, 2024 **job details** summary + $21 - $23 per hour + temp to perm + high ... sales and related occupations + referenceAB_4542978 job details As a Virtual Benefits Advisor that has a valid Health License, individuals will be able to handle… more
- CareFirst (Baltimore, MD)
- …(strategy, design, execution, and optimization) for products and plans in the Medicare , Medicaid, and Federal Employee Health Benefits categories. Leads the team in ... and membership in line with growth objectives, in the Medicare Advantage Bid process annually, the cost and utilization...Market regulations, policies, and nuances, and serve as an advisor on related implementations and task forces. + Manage… more
- LA Care Health Plan (Los Angeles, CA)
- Compliance Advisor III-Privacy Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Compliance Advisor III ensures that the Plan's processes and operations are compliant with all… more
- Randstad US (Dallas, TX)
- wfh - health and life licensed benefit advisor . + dallas , texas (remote) + posted 5 days ago **job details** summary + $25 - $25.50 per hour + temporary + high ... This job might interest you! As a Virtual Benefits Advisor , you can fulfill all the duties of a...drug, vision, and dental plans, as well as advising Pre- Medicare eligible recipients on their options. If you are… more
- LA Care Health Plan (Los Angeles, CA)
- Compliance Advisor II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... support the safety net required to achieve that purpose. Job Summary The Compliance Advisor II ensures LA Care business units are compliant with all Product Lines'… more
- Alight (TX)
- …Learn more at careers.alight.com. **Would you like to help senior consumers navigate Medicare healthcare insurance options? This role is available in all US states ... **Join our Retiree Health Solutions Team** Our team provides Medicare health insurance services to the retiree community. We...solutions. **About the role** As a Temporary Virtual Benefit Advisor , you will sell and enroll retirees into appropriate… more